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Challenges to Vaccination Mandates

“Growing resistance to vaccines, problems enforcing mandates, and judicial and legislative pressure for wide religious exemptions make it timely to reflect on the future of vaccine mandates,” write authors of a Viewpoint article. “Even as evidence grows that mandates work, the political reality is that they will be strongly contested. The question for policymakers, therefore, is when they are worth defending.”

Dropping vaccines required for school entry “would likely have devastating consequences, including for children and families,” the authors conclude. “Vaccine mandates for health care and long-term care workers are also essential to lower morbidity and mortality. Employers should stay abreast of evolving legal understandings, rejecting attempts to assert nonreligious reasons for refusal while giving a wide berth to employees who have sincere religious beliefs.

“Populationwide mandates are useful but more fraught means of ensuring wide vaccine coverage. Enforceability is critical, making colleges and businesses the optimal loci for mandates. Where mandates are not feasible, government can boost vaccine uptake through evidence-based nudges and supports, including COVID-19–era innovations such as requiring proof of vaccination to access public venues such as restaurants or entertainment events and paying cash incentives. Simple behavioral cues, such as routine vaccinations with ‘opt-out’ provisions, increase vaccination coverage. Yet the courts are making it increasingly difficult to wield an old and effective weapon in the public health arsenal to fight new threats.”

Source: JAMA